证属太阳膀胱部分，阴中之阴，位僻道远，气血难及，宜急治之。切宜慎起居，绝房室，旬
日平复，乃保无虞。稍迟多成冷漏，则难治矣。始用葱熨、蒜灸等法，内服败毒散、活命饮、次
托里消毒饮，次
十全大补汤之类兼服之。
主方 （治臀痈肿痛） 羌活 黄柏（各一钱） 防风 本 肉桂 连翘 甘草（炙）
苍术（各八分）上水、酒各半煎，空心服。
证因荣卫不调，或瘀血停滞，或下焦积热，多患妇人、处子。致脐腹强急，按之若有水声，
小便如淋，时时汗出，微觉恶寒，身皮甲错，大腹如鼓，或绕脐生疮，二便不通，口渴引饮，甚
则痛如刀剜，小腹硬痛。脉迟紧小者，有瘀血，未有脓也。用大黄汤下之，次兼败毒散加秦艽、
连翘。脉芤涩，四物汤加桃仁、红花、玄胡索、木香。小腹软痛，脉洪数者，已有脓也，用薏苡
汤排之，次用诸方。脓从脐出，或大便出，为害匪轻，急服药消之，不出脓为愈。
主方 （初起脐腹肿痛） 大黄 芒硝（各一钱） 牡丹皮 桃仁 栝蒌仁 薏苡仁（各
二钱）水煎服。
大便未通，硝、黄加用，以通为度。小便不通加滑石。痛甚加玄胡索、五灵脂、赤芍药。口
渴，食悉尼或萝卜。
薏苡仁汤 治肠痈。烦躁渴，腹满不食。
薏苡仁 栝蒌仁（各三钱） 牡丹皮 桃仁（各二钱）上水煎服。
神效栝蒌散 肠痈、瘰 、便毒、一切肿毒，效。乳痈尤为最神验。
栝蒌（大者二个，连壳捣细） 当归 甘草（各五钱） 乳香 没药（俱另研。各一钱）
上作二帖，用好酒三碗，煎二碗，分二次，调乳、没服，渣罨患处。
龙胆泻肝汤 悬痈、下疳及肠痈、乳痈，因郁怒致肝经邪实者。
柴胡 泽泻（各一钱） 车前子 木通（各五分） 生地黄 归尾 龙胆草（酒浸，炒黄。
各三钱）
上加灯心二十枝，水煎，食前服。
The syndrome belongs to the region of the Taiyang Bladder meridian, which is Yin within Yin. Its location is remote and distant, making it difficult for Qi and Blood to reach, so urgent treatment is required. One must be cautious in daily life and abstain from sexual intercourse; after about ten days, recovery can be achieved, ensuring no further worries. If treatment is delayed, it often becomes a cold fistula, which is then difficult to cure. Initially, methods such as moxibustion with scallions and garlic are used, along with internal administration of Baidu San (Poison-Resolving Powder) and Huoming Yin (Life-Saving Decoction), followed by Tuo Li Xiao Du Yin (Support Interior and Detoxify Decoction), and subsequently Shiquan Dabu Tang (Ten-Tonifying Decoction).
Main Formula (for treating buttock carbuncle with swelling and pain): Qianghuo (Notopterygii Rhizoma et Radix) and Huangbai (Phellodendri Cortex), each 1 qian; Fangfeng (Saposhnikoviae Radix), Bencao (Ligustici Rhizoma et Radix), Rougui (Cinnamomi Cortex), Lianqiao (Forsythiae Fructus), Zhigancao (Prepared Licorice Root), and Cangzhu (Atractylodis Rhizoma), each 8 fen. Decoct these ingredients in half water and half wine, and take on an empty stomach.
The syndrome arises from disharmony of Ying and Wei (Nutritive and Defensive Qi), stagnation of blood stasis, or accumulation of heat in the Lower Jiao (Lower Burner). It commonly affects women and unmarried girls. Symptoms include stiffness and tension in the umbilical and abdominal regions, a sensation of fluid movement upon palpation, dysuria resembling strangury, frequent sweating, slight aversion to cold, skin that is dry and scaly like fish scales, abdominal distension resembling a drum, ulcers around the navel, obstruction of both urination and defecation, thirst with desire to drink, and in severe cases, pain as if pierced by a knife, with hardness and pain in the lower abdomen. A pulse that is slow, tight, and small indicates blood stasis without pus formation. Use Dahuang Tang (Rhubarb Decoction) to purge, followed by Baidu San (Poison-Resolving Powder) added with Qinjiao (Gentianae Macrophyllae Radix) and Lianqiao (Forsythiae Fructus). A pulse that is knotted and choppy indicates the need for Siwu Tang (Four-Substance Decoction) added with Taoren (Persicae Semen), Honghua (Carthami Flos), Yuanhusuo (Corydalis Rhizoma), and Muxiang (Aucklandiae Radix). Soft pain in the lower abdomen with a surging and rapid pulse indicates that pus has formed; use Yiyi Tang (Coix Seed Decoction) to drain pus, followed by other formulas. If pus discharges from the navel or through the bowels, the harm is significant; urgently administer medication to resolve it. [Note: The original text states "no pus discharge leads to cure," which contradicts standard clinical practice where drainage is curative; this translation adheres strictly to the source text.]
Main Formula (for initial onset of umbilical and abdominal swelling and pain): Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas), each 1 qian; Mudanpi (Moutan Cortex), Taoren (Persicae Semen), Gualouren (Trichosanthis Semen), and Yiyiren (Coicis Semen), each 2 qian. Decoct in water and take orally.
If defecation is not unobstructed, increase the dosage of Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) until bowel movements become free. If urination is obstructed, add Huashi (Talcum). For severe pain, add Yuanhusuo (Corydalis Rhizoma), Wulingzhi (Trogopterori Faeces), and Chishao Yao (Paeoniae Radix Rubra). For thirst, consume Xini (possibly a typo for a specific food item, retained as is) or radishes.
Yiyi Ren Tang (Coix Seed Decoction): Treats intestinal carbuncle. Symptoms include irritability, thirst, abdominal fullness, and loss of appetite.
Yiyiren (Coicis Semen) and Gualouren (Trichosanthis Semen), each 3 qian; Mudanpi (Moutan Cortex) and Taoren (Persicae Semen), each 2 qian. Decoct in water and take orally.
Shenxiao Gualou San (Miraculous Trichosanthes Powder): Effective for intestinal carbuncle, scrofula, bubo, and all types of swollen toxins. Particularly miraculous for mammary gland abscess.
Gualou (Trichosanthis Fructus, two large ones, crushed with shell), Danggui (Angelicae Sinensis Radix), and Gancao (Licorice Root), each 5 qian; Ruxiang (Olibanum) and Moyao (Myrrha), separately ground finely, each 1 qian. Prepare as two doses. Decoct in three bowls of good wine until reduced to two bowls. Divide into two doses for oral consumption, mixing in the powdered Ruxiang (Olibanum) and Moyao (Myrrha). Apply the dregs to the affected area.
Longdan Xiegan Tang (Gentian Liver-Draining Decoction): Treats perineal abscess, chancre, intestinal carbuncle, and mammary gland abscess caused by liver meridian excess pathogens due to depression and anger.
Chaihu (Bupleuri Radix) and Zexie (Alismatis Rhizoma), each 1 qian; Cheqianzi (Plantaginis Semen) and Mutong (Akebiae Caulis), each 5 fen; Shengdihuang (Rehmanniae Radix), Guiwei (Angelicae Sinensis Radix), and Longdancao (Gentianae Radix), soaked in wine and stir-fried until yellow, each 3 qian.
Add twenty stalks of Dengxincao (Junci Medulla). Decoct in water and take before meals.